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NPI Code Detail

MEDICARE: DR. MALINDA BERNING PENCE O.D.

MEDICARE: DR. MALINDA BERNING PENCE O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOH 5060OH

General Provider Information

NPI Number : 1649277062
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MALINDA BERNING PENCE O.D.
Provider Business Mailing Address
First Line : 6725 MIAMI AVE STE 101
Second Line :
City : CINCINNATI
State : OH
Zip : 45243-3158
Country : US
Telephone Number : 513-561-7076
Fax Number : 513-561-2066
Provider Business Practice Location Address
First Line : 6725 MIAMI AVE STE 101
Second Line :
City : CINCINNATI
State : OH
Zip : 45243-3158
Country : US
Telephone Number : 513-561-7076
Fax Number : 513-561-2066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 10/21/2022

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Directions to “ DR. MALINDA BERNING PENCE O.D.” Practice Location

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